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FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: 602 S Genoa Drive City: Santa Ana State:CA ZIP Code:92704 The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Section A, B, C, E, G, or H of this Elevation Certificate. Complete the applicable item(s) and sign below when: G1.The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by state law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.a.A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zone AR/AO, or when item E5 is completed for a building located in Zone AO. G2.b.A local official completed Section H for insurance purposes. G3.In the Comments area of Section G, the local official describes specific corrections to the information in Sections A, B, E and H. G4.The following information (Items G5–G11) is provided for community floodplain management purposes. Permit Number: G8. This permit has been issued for:New Construction Substantial Improvement G9.a. Elevation of as-built lowest floor (including basement) of the building:Datum:metersfeet G9.b. Elevation of bottom of as-built lowest horizontal structural member:Datum: G10.a.BFE (or depth in Zone AO) of flooding at the building site:Datum: G10.b. Datum: Community's minimum elevation (or depth in Zone AO) requirement for the lowest floor or lowest horizontal structural member: G11.Variance issued?Yes No If yes, attach documentation and describe in the Comments area. The local official who provides information in Section G must sign here. I have completed the information in Section G and certify that it is correct to the best of my knowledge. If applicable, I have also provided specific corrections in the Comments area of this section. NFIP Community Name: Local Official's Name:Title: Comments (including type of equipment and location, per C2.e; description of any attachments; and corrections to specific information in Sections A, B, D, E, or H): SECTION G – COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL COMPLETION) G6. Date Permit Issued: Date Certificate of Compliance/Occupancy Issued: G5. G7. metersfeet metersfeet metersfeet Address: City:State:ZIP Code: Ext.:Email:Telephone: Signature:Date: FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22)Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19